British journal of nursing (Mark Allen Publishing)
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Promoting an environment conductive to sleep in hospital is a challenge. Although patients may appear to sleep in hospital, it may not be refreshing or restorative. ⋯ Nurses can help their patients by understanding what influences sleep patterns and acting on this knowledge. This may include a variety of interventions, from allowing patients to carry out their own bedtime routine, to explaining to elderly people how their sleeping patterns changes with age.
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This article provides an overview of breakthrough pain in cancer patients, what causes it, current treatment options and the impact it has on individuals. It considers the importance of accurate assessment, the use of assessment tools and the growing role of nurses in managing this challenging pain syndrome. ⋯ While many advances have been made in the treatment of pain, there is still room for improvement in both the pharmaceutical and general management of the condition. Suggestions are made as to how these may be met.
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Following the establishment of an acute pain service in one UK acute NHS trust, including the introduction of patient-controlled analgesia (PCA), pain scoring, and a rationalization of the use of simple analgesics, attention was drawn to an apparent increase in postoperative nausea and vomiting (PONV) among women given PCA following abdominal hysterectomy. Audits were conducted into clinical practice and patient satisfaction and it was agreed that an evaluation of the evidence should be conducted to ensure that the correct direction for development in the management of PONV could be established. ⋯ The possibility of adding antiemetics to the analgesic solution, and the choice of antiemetic drugs, are investigated. Other factors that can affect the incidence of PONV in patients with PCA are also discussed, and an auditable framework for the evaluation of clinically effective practice is suggested.
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This article outlines the rationale behind an approach developed at the National Primary Care Research and Development Centre (NPCRDC) to improve patients' abilities to self-manage their conditions with the support of services provided by the NHS. The approach is systematic and requires involvement of patients in the development of information, changing access arrangements to health services and promoting a patient-centred approach to care. A programme of research and development is currently being undertaken at The University of Manchester by researchers based at NPCRDC to investigate the effectiveness of this approach. The evidence base for the strategy under investigation is discussed and proposals are made for the role of nurses as facilitators for the self-management agenda in the NHS.
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The ageing process can bring with it an increased incidence of conditions which give rise to chronic pain. Persistent musculoskeletal and/or neuropathic pain due to conditions such as back pain, arthritis, osteoporosis and diabetes in elderly people can lead to a marked deterioration in their quality of life. ⋯ Pain management can be difficult due to the existence of multiple medical problems and the increased incidence of side-effects related to the treatment. This article aims to update nurses on the assessment and management of pain in the older adult, and will provide a broad overview of pain management strategies suitable for elderly patients.